Monica Tanaka

Monica is our Physiospot Editor. She is a trained journalist with a keen interest in the physiotherapy profession. As Physiospot Editor, Monica explores stories and physiotherapy news for us with fresh eyes. She is a science and health communicator with experience implementing strategic communications in the not-for-profit, academic, and public sectors. Thanks to physiotherapists, Monica has kept up her love of cross-country skiing and cycling over the years.

UK physiotherapist talks about response to Nepal earthquake

One year ago today, a 7.8 earthquake – the largest in over 20 years – hit central Nepal, killing 8,000 people and injuring over 22,000. What was the response and what still needs to be done?

For people injured as a result of natural disasters, physical rehabilitation is the first step towards regaining independence. Especially in emergency responses, rehabilitation plays a vital role in preventing any sustained injuries from developing into long-term disabilities.

Peter Skelton, a physiotherapist and Rehabilitation Project Manager with Handicap International, talks through his experience of deploying to the Nepal earthquake last year as part of the UK Emergency Medical Team, and explains what steps still need to be taken on the path to recovery.

And as we mark the first anniversary of the Nepal earthquake, Peter also shares fantastic news about Handicap International’s Every Step Counts campaign. Read on to see how your support today could have a massive impact, as all donations until the July 18, 2016 will be doubled by the UK government!

By the time we arrived, it was already clear that the Nepalese had done a fantastic initial job caring for the injured.

I already knew a lot about Handicap International’s program in Nepal, which had included working with the Ministry of Health and the major hospitals to strengthen their preparedness for a disaster just like this, and despite the tragedy of the earthquake, it was great to see how well prepared the response was.

Our national teams had started work immediately, and were already in place providing vital equipment and rehabilitation on the first day of the earthquake.

How did the health system in Nepal cope with the disaster? What were the main needs in terms of rehabilitation?

The health system was well prepared and the international response was also well coordinated. In a way Nepal was lucky, as Kathmandu was not as badly affected as we had feared it might be, but there were still a huge number of people with injuries being brought in, particularly from the more remote areas.

The main needs were identifying people with injuries and with disabilities, and then providing them with the early rehabilitation and equipment they needed, because we know if we miss people early in the disaster response, they may then slip through the net, and never get the care they need, which can place their lives at risk, or mean that they don’t make the recovery they could have made.

Could you give some more detail about the deployment from your perspective? What were the main challenges? How do you remember this experience one year on?

Disaster responses are always incredibly complicated, and can be misportrayed in the media as being about people from the west heroically helping passive victims.

My strongest memory from every disaster I have worked in, and Nepal in particular, has been the incredible work of those living in the disaster area, and the incredible resilience of those affected.

One colleague had lost his family home, and his elderly parents were living in a tent in the mountains as a result, and yet every day without pause or complaint he arrived to work and went about his vital duties.

Is there one story in particular that stayed with you?

One day we learned of a lady who had injured her spine but had been sent home from hospital to a distant village. We made enquiries, and were worried enough that we coordinated with the Spinal Injury Rehabilitation Centre (SIRC) to go and find her.

Once we arrived, we found she not only had a spinal cord injury, but that she had not received any follow up or referral. She was lying in a partially destroyed house, with her family caring for her as best as they could.

We were able to safely transfer her to the spinal injury unit, where she received the surgery and rehabilitation she needed, and I hear she is now doing really well.

Why are rehabilitation and physiotherapy so important at a time of an emergency? What difference can early treatment make to the life of a person who suffered an injury as a result of the earthquake?

In earthquakes, as rehabilitation providers, we face two main challenges. Firstly, often patients are never referred to rehabilitation, and so patients whose lives would be transformed by simple rehabilitation miss out. We are doing a huge amount of work to try to change this.

Secondly, because not many organisations provide high-quality early rehabilitation in disasters, many people develop complications like pressure sores or contractures, or become dependent on their families when they could be independent. The great tragedy is that often these people have already lost their homes and their livelihoods. With some simple rehabilitation they could quickly become independent and again support their families, but instead their families are caring for them.

In the longer term, what are the challenges facing earthquake survivors with life-changing injuries? What are their rehabilitation needs and how will these be met?

One of the great challenges of working in a disaster is that the world’s attention quickly moves on, but those people with injuries like amputations and spinal cord injuries are left with lifelong difficulties. For them, rehabilitation is only part of what they need – if their society does not include them or treat them with equality, they may also face challenges being able to work, or access education or healthcare.

An important part of Handicap International’s longer term response is making sure that people with disabilities are better included in their societies, in particular in the aftermath of disasters. Strangely, often disasters provide an opportunity to “build back better” and I see positive signs that this will be the case for people with disabilities in Nepal.

What advice would you give to fellow physiotherapists wanting to get involved?

It’s fantastic that so many physiotherapists want to get involved in helping people affected by disasters. We have recently published a briefing paper with WCPT.

For those that aspire to work in disaster zone, there is now clear guidance from all of the international rehabilitation societies about how to do this. You should register in advance of a disaster with an international NGO like Handicap International, or with your national Emergency Medical Team, and get trained to work effectively in a humanitarian environment.

After visiting another patient, Handicap International physiotherapist Pete Skelton provides a screening assessment for a young child living in an UNRWA shelter. The child?s mother was afraid that she had a problem with her walking. Happily, it was part of her normal development and her mother was relieved that everything was fine.

The critical thing is to help before a disaster strikes, by supporting organisations that have a long-term presence in countries at risk of, or recovering from disasters. That’s why I am so passionate about the work Handicap International does and about a brand-new campaign we are launching today!

Handicap International’s Every Step Counts appeal aims to raise essential funds to help disabled and injured people walk again by supporting sustainable rehabilitation care in countries that need it most, just like Nepal.

From now until 18th July, every pound raised to support people with disabilities will be doubled by the UK government, enabling twice as many disabled children to walk again. So there has never been a better time to support rehabilitation work!

So please, take a step today. To donate, visit www.everystepcounts.org.uk or call 0870 774 3737. Or why not get your colleagues involved and organise a fundraising event at work? To order your fundraising pack, email [email protected]

You can make a real difference by providing a disabled person with a wheelchair, or giving physiotherapy sessions to help an amputee walk again. Every step you take, and every pound you give, counts!